Early life and in utero factors found to influence testicular function in adulthood

...London 8 July 2013: Studies over the past 20 years have suggested (th...The study which found that adverse fetal growth exposure to maternal...The study was based on follow-up of the Western Australian Pregnancy (...Results showed that around one in six of the men tested had sperm para...

London, 8 July 2013: Studies over the past 20 years have suggested (though not unequivocally
confirmed) that semen quality is in decline, reflected most evidently in falling sperm counts and
reduced sperm motility.(1) The explanations have been controversially attributed to
environmental factors (such as exposure to toxins) and to male smoking. Now, a new study
based on a 20-year follow-up of one of the world's largest study cohorts, suggests that
exposure to several factors in utero and in early life may also lead to reduced semen
parameters in adulthood - and potentially to a decline in male fertility.

The study, which found that adverse fetal growth, exposure to maternal smoking, and a lower
childhood growth trajectory were all associated with a subsequent decline in testicular function,
is reported today at the annual meeting of ESHRE by Roger Hart, Professor of Reproductive
Medicine at the University of Western Australia and medical director of Fertility Specialists of
Western Australia in Perth.

The study was based on follow-up of the Western Australian Pregnancy (Raine) Cohort, which
began in 1989-91 with the enrolment of 2900 mothers during pregnancy; their babies had
regular assessment from birth, which included fetal growth measurements. Part of the 20-year
follow-up of this cohort (in 423 of the men at the age of 20-22 years) involved a testicular
assessment, which included measurement of testicular volume, analysis of semen quality and
hormone production - as well as body composition for fat distribution.

Results showed that around one in six of the men tested had sperm parameters below the
"normal" threshold recently defined by the World Health Organization (WHO). That is:

14.8% were below the threshold of 1.5 ml seminal volume

18.9% below the threshold of 39 million total sperm

17.5% below the threshold of 15 million sperms/ml sperm count

14.4% below the threshold of 32% motility

In addition, a quarter of the subjects (26.4%) had sperm whose appearance (morphology) did
not meet the WHO's acceptable criteria.

When these results were correlated with the earlier fetal growth assessments, being
consistently small in utero was associated with a significantly greater chance of having a sperm
assessment within the lowest quartile of all the men assessed; men with good intrauterine
growth were less likely to be in this lowest quartile of sperm production in adulthood. Being
exposed to their mothers' smoking (18.6% of men) was also associated with lower sperm
production.

Commenting on the results, Professor Hart proposed that poor fetal growth, exposure to
maternal smoking, poor childhood growth patterns, increased fat deposition in adolescence, and
smoking and drug use in adulthood may ultimately lead to reduced semen parameters. Hence,
public health measures to address these influences may help to reduce these risks in the future.
Professor Hart said: "The main message from our study is that to reach adulthood with the best
possible testicular function a man should not be exposed to his mother's smoking, should have
good fetal growth and, in childhood and through adolescence, should be 'appropriately grown' -
that is, neither underweight nor overweight, and as an adult should not smoke or take drugs."

On the question of environmental "endocrine disruptors" as an explanation for a decline in
semen quality, Professor Hart added: "The extent of the risk posed by environmental endocrine
disrupters is still unclear, but some researchers do attribute the perceived decline in sperm
counts to these chemicals within the environment. We do not have any evidence to suggest
such a link in our study, but we do intend to measure the fetal exposure to endocrine
disrupting chemicals from maternal blood that was stored in 1990, prior to the study recruits'
birth, and to relate these chemical exposures to the men's semen counts in 2012-3."

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